dactinomycin at a glance
Medicine class
Cytotoxic antineoplastic antibiotic
Administration
Given by trained cancer-care professionals, usually into a vein; it is not taken by mouth.
Key monitoring
Blood counts and liver and kidney function require frequent assessment.
What is dactinomycin used for?
UK-licensed uses include:
Wilms' tumour, childhood rhabdomyosarcoma, Ewing's sarcoma and metastatic non-seminomatous testicular cancer as part of combination or multimodal treatment
Gestational trophoblastic neoplasia, alone or with combination chemotherapy
Locally recurrent or locoregionally metastatic melanoma through regional perfusion with melphalan
How does dactinomycin work?
Dactinomycin binds to DNA and disrupts DNA-dependent RNA production. This suppresses cell proliferation, particularly in rapidly dividing tissues, but also affects bone marrow, the digestive tract and other healthy tissues.
dactinomycin preparations and strengths
Injection
Route: Parenteral
Strengths: 500 micrograms
How to take dactinomycin
Dactinomycin is prepared and administered by clinicians experienced in chemotherapy. It may be injected or infused into a vein, or used in specialist regional perfusion. Tell staff immediately about burning, stinging, pain or swelling around the infusion site because leakage can cause severe tissue injury.
It must not be taken by mouth.
Food does not affect administration because it is given parenterally.
Keep all planned treatment and blood-test appointments.
dactinomycin side effects
Common or expected effects
- Nausea or vomiting
- Sore mouth, mouth ulcers or difficulty swallowing
- Reduced blood-cell production, increasing infection, anaemia and bleeding risks
- Hair loss
- Diarrhoea or abdominal pain
- Tiredness, fever or feeling generally unwell
- Skin rash
Get urgent medical advice
- Sepsis or febrile neutropenia
- Severe bone-marrow suppression or unusual bleeding
- Liver injury or hepatic veno-occlusive disease
- Severe tissue injury following leakage outside a vein
- Severe allergic reaction
- Stevens–Johnson syndrome or toxic epidermal necrolysis
- Severe gastrointestinal ulceration or mucositis
dactinomycin in pregnancy
Dactinomycin can harm a developing baby and should not normally be used during pregnancy. Discuss pregnancy, pregnancy plans and contraception with the specialist team. Product information advises effective contraception during treatment and for at least seven months afterwards for women, and four months afterwards for men with partners who could become pregnant.
dactinomycin while breastfeeding
Breastfeeding is contraindicated during dactinomycin treatment. Discuss alternatives and future feeding plans with the oncology and maternity teams.
dactinomycin interactions
The treatment team should review medicines and recent or planned radiotherapy before dactinomycin is given.
Radiotherapy
Dactinomycin can intensify radiation-related skin, mucosal, gastrointestinal and bone-marrow toxicity and reactivate inflammation in previously irradiated tissue.
Antibacterial medicines monitored by bioassay
Dactinomycin may interfere with laboratory bioassays used to measure antibacterial medicine levels, so the laboratory should be informed.
Common questions about dactinomycin
Answers are fully visible for fast scanning and source review.
Is dactinomycin an antibiotic?
It is classified as an antineoplastic antibiotic, but its toxicity prevents its use for bacterial infections. Its clinical role is cytotoxic cancer treatment.
How is dactinomycin given?
It is prepared and given by specialist staff, usually through a vein; selected melanoma treatment may use regional perfusion.
Why are blood tests needed?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.